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Does your child have a serious illness?

How can I tell if my baby is seriously ill?

Media last reviewed: 17/01/2015

Next review due: 17/01/2017

If your baby has a serious illness, it’s important to get medical attention as soon as possible.

It can be difficult to tell when a child is seriously ill. Above all, trust your instincts. You know better than anyone else what your child is usually like, so you’ll know what is worrying behaviour. To help you here is a comprehensive checklist of "red alert" symptoms that should always be treated as serious: 

  • a high-pitched, weak or continuous cry
  • a lack of responsiveness, marked slowdown in activity or increased floppiness
  • in babies, a bulging fontanelle (the soft spot on a baby's head)
  • neck stiffness
  • not drinking for more than eight hours (taking solid food is not as important)
  • a temperature of over 38C (100.4F) for a baby less than three months old, or over 39C (102.2F) for a baby aged three to six months old. Read more about how to take your child's temperature
  • a high temperature, but cold feet and hands
  • a high temperature, coupled with quietness and listlessness
  • fits, convulsions or seizures
  • turning blue, very pale, mottled or ashen
  • difficulty breathing, fast breathing, grunting while breathing, or if your child is working hard to breathe – for example, sucking their stomach in under their ribs
  • your baby or child is unusually drowsy, hard to wake up or doesn’t seem to recognise you
  • your child is unable to stay awake, even when you wake them
  • a spotty, purple-red rash anywhere on the body (this could be a sign of meningitis)
  • repeated vomiting or bile-stained (green) vomiting

It can be difficult to know when to call an ambulance or go to the accident and emergency (A&E) department, but use the following as a guide.

Call an ambulance for your child if they:

  • stop breathing
  • are struggling for breath (you may notice their skin being sucked in under the ribcage)
  • are unconscious or seem unaware of what's going on
  • won’t wake up
  • have a fit for the first time, even if they seem to recover

Take your child to A&E if they:

  • have a fever and are persistently lethargic, despite taking paracetamol or ibuprofen
  • are having difficulty breathing (either breathing fast or panting, or they are very wheezy)
  • have severe abdominal pain
  • have a cut that won't stop bleeding or is gaping open
  • have a leg or arm injury that means they can’t use the limb
  • have swallowed a poison or tablets

Again, trust your instincts. You know what’s different or worrying behaviour in your child.

Spotting the signs of type 1 diabetes in a child

Type 1 diabetes is a long-term condition that most commonly starts in children and young adults. It cannot be prevented or cured, and the onset is usually very fast. It can occur at any age, from six months of age onwards.

Type 1 diabetes occurs when the pancreas fails to make any insulin, which is needed to control blood glucose levels. Without insulin, blood glucose levels rise dangerously high and can cause severe illness. 

The main symptoms are:

  • drinking a lot and feeling excessively thirsty
  • passing a lot of urine; full nappies can be a sign of increased urine production
  • bedwetting after having previously been dry
  • weight loss

Other symptoms include:

  • breath that smells like fruit
  • tiredness (lethargy)
  • headaches
  • constipation
  • abdominal pain
  • vomiting
  • vulval thrush

It is vital that type 1 diabetes is diagnosed as early as possible so that treatment can be started. If you believe your child is experiencing symptoms, contact your GP immediately. If it is not picked up at this stage, diabetic ketoacidosis may occur.

Children and diabetic ketoacidosis (DKA)

Diabetic ketoacidosis is a serious life-threatening illness that can occur with type 1 diabetes. It happens when there is so little insulin that glucose cannot be used for energy and the body starts to burn fat instead. This produces "ketones", which make the blood very acidic. DKA can be fatal and always needs urgent medical attention.

The symptoms of DKA include:

  • vomiting
  • deep, sighing respiration
  • a reduced level of consciousness
  • abdominal pain

Not all children will develop all the symptoms listed above. If your child does develop some of these symptoms, seek medical help immediately and ask for a test for type 1 diabetes.

For further help, information and support, call the Diabetes UK Careline on 0345 123 2399.

Spotting the signs of meningitis in children

Meningitis is an inflammation of the membranes that surround the brain. It’s a very serious illness, but if it’s diagnosed and treated early, most children make a full recovery.

There are several types of meningitis, and some can be prevented by vaccinations. For more information, see the NHS vaccination schedule.

Early symptoms of meningitis may be similar to having a cold or flu (these include fever, vomiting, irritability and restlessness). However, children with meningitis can become seriously ill in hours, so it's important to recognise the signs.

The main symptoms of meningitis are:

  • fever (a temperature of 38C (100.4F) or more in babies under three months and 39C (101.2F) or more in babies between three and six months), vomiting and refusing feeds
  • cold hands and feet
  • skin that is pale, blotchy or turning blue
  • rapid or unusual patterns of breathing
  • irritability, especially when picked up (this can be due to limb or muscle pain)
  • a high-pitched, moaning cry
  • shivering
  • red or purple spots that don’t fade under pressure (do the glass test, which is explained below)
  • floppiness and listlessness, or stiffness with jerky movements
  • children may be drowsy, less responsive, vacant or difficult to wake
  • a stiff neck
  • in babies, a bulging fontanelle (the soft spot on a baby's head)

Not all children will develop all the symptoms listed above. If your child does develop some of these symptoms, especially red or purple spots, seek urgent medical help.

Rashes look different on different people. The colour of spots can vary and may be less easy to see on dark skin. If in doubt, check with your GP, health visitor or pharmacist, or you can call NHS 111.

If you can’t get in touch with your GP, or you're still worried after you’ve spoken to them, take your child to the A&E department of your nearest hospital.

The meningitis glass test

If your child has red or purple spots, press the side of a clear drinking glass firmly against the rash to see whether the spots fade and lose colour under pressure. If they don't change colour, contact your GP immediately.

This rash can be harder to see on darker skin, so check for spots over your baby’s whole body. They may show up on paler areas, such as the palms of the hands, soles of the feet, tummy, inside the eyelids and the roof of the mouth.

For more information, contact one of the following organisations:

You can also contact your GP, practice nurse or health visitor for advice, or call NHS 111.

Retinoblastoma warning sign: pupil reflects white

Spotting eye cancer (retinoblastoma)

Retinoblastoma is a rare cancer that affects the eyes of children under five years old. It is usually caught and treated early in the UK, which is why most children with retinoblastoma are successfully treated.

A sign of retinoblastoma is the pupil of one of your child's eyes looking odd – for example, reflecting white like a cat's eye. This may be noticed in photos in which the pupil of the healthy eye appears red from the flash, or in a dark room or a room lit by artificial light. Another symptom can be a squint, when the child's eyes look in different directions.

If your child has these symptoms, they may be due to something other than retinoblastoma, but you should still get them checked by a GP as soon as possible.

More information on serious childhood illnesses

Page last reviewed: 22/04/2014

Next review due: 22/04/2016


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